Kailas Maya, Lu Hsun Ming Simon, Rothman Emily F, Safer Joshua D
Endocr Pract. 2017 Jul;23(7):780-786. doi: 10.4158/EP161727.OR. Epub 2017 Apr 27.
Transgender individuals now have many options for medical intervention, including gender-affirmation surgeries. However, it is unknown how common it is for transgender individuals to undergo these surgeries. The purpose of this cross-sectional study was to assess the prevalence of gender-affirming surgeries among transgender patients in 2015, which was immediately prior to insurance changes that made gender-affirming surgery more affordable for Massachusetts residents.
A retrospective chart review of 99 transgender patients was performed at the Endocrinology Clinic at Boston Medical Center, an urban safety net hospital. The records for 99 transgender subjects who received treatment between 2004-2015, including 28 transmen and 71 transwomen, were examined. The outcome measures were the types of medical interventions chosen by transgender patients, which included hormone therapy, chest surgery, gonadectomy, genital surgery, and facial surgery.
Thirty-five percent of subjects had undergone at least one gender-affirming surgery. Transmen were more likely to have had surgery than transwomen (54% vs. 28%). Twenty-five percent of patients had chest surgery, 13% had genital surgery or gonadectomy, and 8% had facial surgery.
In 2015, a majority of transgender endocrinology clinic patients had not undergone any type of gender-affirmation surgery. Among those who did elect to have a surgery, genital surgery or gonadectomy were uncommon. The low rate of surgery among this sample of transgender patients may be attributable to the financial cost, lack of interest in surgery, or that genital surgery is not a high priority for transgender individuals relative to surgery to change visible features such as face and chest. Abbreviation: HT = hormone therapy.
跨性别者现在有多种医疗干预选择，包括性别肯定手术。然而，尚不清楚跨性别者接受这些手术的普遍程度如何。这项横断面研究的目的是评估2015年跨性别患者中性别肯定手术的患病率，这是在保险政策变化之前，该变化使马萨诸塞州居民更容易负担性别肯定手术的费用。
在城市安全网医院波士顿医疗中心的内分泌诊所对99名跨性别患者进行了回顾性病历审查。检查了2004年至2015年期间接受治疗的99名跨性别受试者的记录，其中包括28名男性变女性者和71名女性变男性者。结果指标是跨性别患者选择的医疗干预类型，包括激素治疗、胸部手术、性腺切除术、生殖器手术和面部手术。
35%的受试者至少接受过一次性别肯定手术。男性变女性者比女性变男性者更有可能接受手术（54%对28%）。25%的患者接受了胸部手术，13%接受了生殖器手术或性腺切除术，8%接受了面部手术。
2015年，大多数跨性别内分泌诊所患者未接受任何类型的性别肯定手术。在那些选择进行手术的患者中，生殖器手术或性腺切除术并不常见。该跨性别患者样本中的低手术率可能归因于经济成本、对手术缺乏兴趣，或者相对于改变面部和胸部等可见特征的手术而言，生殖器手术对跨性别者来说不是高度优先事项。缩写：HT = 激素治疗。
